Recent Issue

Archives of Psychiatry and Psychotherapy 2/2010
 

 
Monika Dmitrzak-Węglarz, Maria Skibińska, Aleksandra Szczepankiewicz, Anna Leszczyńska-Rodziewicz, Paweł Kapelski, Piotr Czerski, Joanna Hauser
5 Association analysis of polymorphisms of the NTRK2 and BDNF genes with bipolar affective disorder in a Polish sample
Summary
Aims. Neurodevelopmental abnormality has been implicated in the pathogenesis of bipolar disorder. The neurotrophin BDNF regulates not only cell survival, proliferation and synaptic growth in the developing CNS, but also plays a crucial role in activity–dependent neuroplasticity. Substantial evidence has pointed to the role of the BDNF in the pathophysiology of mood disorders and in the mechanism of action of therapeutic agents. Consequently, BDNF and its receptor, encoded by the NTRK2 gene, constitute good candidates for molecular genetic studies in bipolar affective disorder (BPD).
Methods. In the present study we selected four single nucleotide polymorphisms (SNPs) of the BDNF and three SNPs of the NTRK2 genes. The case–controlled analyses were performed on patients with bipolar disorders (n=455, control n=589) and in the subgroups of patients, formed by using the following criteria: the clinical type of BPD (BPD type I & II), gender, age of onset, family history of (BPD) and a history of suicidal attempts.
Results. The haplotype GC (rs988748/rs203024) of the BDNF gene was significantly more frequent in patients with BPD then in controls (p=0.006). Also haplotype CA (rs 1187326/rs1187327) of the NTRK2 gene was significantly more frequent in patients than in the control group (p=0.046). Case-control analysis of single markers after adjusting the significance level for multiple tests did not show any significant differences.
Conclusions. These data suggest that polymorphisms of BDNF and NTRK2 genes may be involved in the aetiology of bipolar disorder in the Polish population.

Renata Modrzejewska, Jacek Bomba
19 A comparative study of adolescent depression among high school pupils in a large Polish city
Summary
Aim. This study aims to evaluate changes in the symptoms of adolescent depression during a 17-year period.
Methods. The Kraków Depression Inventory (KID), version IO “C1” was administered to 17-year-old pupils of Kraków’s high schools in 1984 and 2001. The groups studied were selected using two-stage sampling. The KID IO “C1” results of the pupils who were screened as depressive (153 in 1984; 522 in 2001) were analysed.
Results. Statistical analysis revealed significant differences in Mood Scale results (higher in girls than boys; higher in girls in 2001 than 1984), Anxiety Scale (lower in 2001 than 1984 in both gender groups), Self-destruction Scale (higher in girls in 2001 than 1984; higher in boys than girls), Somatisation Scale (higher in girls than boys). Cognition and Activity Level Scale showed no significant differences.
Conclusions. The prevalence of adolescent depression has remained stable over time. The manifestation of adolescent depression has changed towards externalisation in self-destructive behaviour.

Dorota Warzocha, Tomasz Pawełczyk, Agnieszka Gmitrowicz
25 Associations between deliberate self-harm episodes in psychiatrically hospitalised youth and the type of mental disorders and selected environmental factors
Summary
Aim. The objective of the study was to assess possible relationships between the occurrence of deliberate self-harm (DSH) in young patients during their psychiatric treatment and the presence of specific mental disorders, or the history of suicide attempts, the exposure to abuse and their family situation.
Material. The studied group consisted of 187 in-patients, aged 13-19 years, hospitalised at the Adolescent Ward of the Central Teaching Hospital, Medical University of Łódź, during 2 quarters: on the turn of 2005 and at the beginning of 2006.
Method. All patients were psychiatrically examined and, on discharge, they were assessed with the “Questionnaire for the Assessment of Self-Harm” designed for the purpose of this study.
Results. Forty-seven percent of the psychiatrically treated in-patients had performed DSH acts. A strong relationship (p<0.001) was found between the occurrence of DSH and the previous history of suicidal attempts, the presence of an alcoholic problem in the family, exposure to sexual and physical abuse and the lack of support from close family members.
Conclusions. There was no relationship between the occurrence of deliberate self-harm in young in-patients and the presence of a specific psychiatric disorders.

Marcin Kwiatkowski
33 Perception of parental attitudes in homosexual, bisexual and heterosexual individuals
Summary
Aim. The aim of the study was to analyse the perception of paternal and maternal attitudes in homosexual, bisexual and heterosexual groups.
Methods. The study involved the Parental Attitude Scale developed by Plopa. The project included 177 participants; specifically, the sample comprised 39 homosexual, 15 bisexual and 31 heterosexual women, and 56 homosexual, 5 bisexual and 31 heterosexual men.
Results. The study showed significant differences between homosexual and heterosexual women in their perceptions of maternal attitudes in terms of the Over-protective Attitude Scale (p=0.029), and between heterosexual and bisexual women in terms of the Autonomy Attitude Scale (p=0.036), the Over-protective Attitude Scale (p=0.004) and the Over-demanding Attitude Scale (p=0.007). There were no significant differences in the perception of maternal attitudes between homosexual and heterosexual men. The study showed significant differences in the perception of paternal attitudes in terms of the Inconsequential Attitude Scale between homosexual and bisexual women (p=0.023) and between heterosexual and bisexual women (p=0.035). There were no significant differences in the perception of paternal attitudes between homosexual and heterosexual women and between homosexual and heterosexual men.

Grzegorz Mączka, Marcin Siwek, Michał Skalski, Bartosz Grabski, Dominika Dudek
45 Patients’ and doctors’ attitudes towards bipolar disorder – do we share our beliefs?
Summary
beliefs regarding the most important aspects of bipolar disorder (BD) treatment.
Method. A group of 100 psychiatrists (with at least 5 years’ professional experience) and a group of 100 remitted patients fulfilling ICD-10 and DSM-IV-TR BD criteria (aged 18–65) were enrolled. Their beliefs were investigated with a 41-item structuralised questionnaire (doctors group) and 27-item self evaluation inventory (patients group). The structures of both tools made it possible to compare the results and were based on hierarchical ranking of answers included in each item.
Results. A number of important concordances were indicated between doctors’ and patients’ beliefs, e.g. both groups considered that: 1/ depression is the most burdensome episode in the course of BD; 2/ pharmacotherapy is the most crucial element of treatment; 3/ improvement in quality of life is the most important aspect of recovery. On the other hand, the results revealed that patients are convinced that doctors consider improving their life quality much less important than alleviating symptom severity. The hierarchy of problems proposed by the patients as the main obstacles in taking drugs appeared to be the exact antithesis of doctors’ beliefs on this issue. The patients indicated the side effects of drugs as the main cause, whereas doctors considered compliance a crucial problem. Discrepancies in beliefs were also observed regarding the perceived importance of different psychoeducation topics: coping abilities and quality of life improvement – the two most important issues in patients’ opinion were placed in a remote rank in the doctors’ hierarchy, giving way to early recognition of relapse symptoms and suicidality prevention.
Conclusion. Discrepancies in psychiatrists’ and patients’ beliefs regarding crucial aspects of BD treatment revealed in the study may be responsible for the worsening of quality of compliance.

Paweł Glita
53 Usefulness of the concepts of deficit and defect in the psychotherapeutic process
Summary
The aim of this article is to outline the usefulness of such categories as deficit and defect during the process of psychotherapy in psychodynamic terms. Because there is no one common definition of these concepts, first the author analyses how they are used in clinical practice (we talk about e.g. “cognitive” or different “emotional” deficits, “organic” or “post psychotic” defects). Sometimes these phrases have very pessimistic connotation for the outcome of psychotherapy. The author refers to different psychoanalytical theories (e.g. H. Kohut, M. Balint, H. Deutsch, F. Pine) to show that these concepts have their origins in two sources. First is the accumulation of psychological and neuropsychological knowledge on the determinants of irreversible changes in the patient’s personality, which are located in his/her brain functioning, early relationships or developmental environment. The second is the strong experience of countertransference inefficacy and limits of psychotherapy as the method of facilitating positive changes in the patient’s life. Clinical illustrations are used to show therapeutic implications of the concepts of deficit and defect. The author focused on the necessity of distinction between deficit and dissociation, interpersonal nature of deficit and defect diagnosis and the possible determinants and consequences of premature diagnosis of deficit or defect.

Katarzyna Prot
63 Research on consequences of the Holocaust
Summary
The paper presents a shift in the research focus concerning the Holocaust survivors – from investigating symptoms of post-traumatic stress disorder to discovering the sources of strength enabling their survival. A brief chronological overview of studies on the Holocaust survivors is presented. Moreover, a number of psychological problems most often experienced by the survivors are identified, including their non-acceptance of separation, fear of closeness, difficulty in defining personal and social identity, susceptibility to hurt feelings, and a sense of guilt.

Paweł Bronowski, Maryla Sawicka, Sylwia Kluczyńska, Karina Kosznik-Waląg
73 The use of the Internet to break the mental disability. Self-experience
Summary
The article under consideration is about the use of computers, especially the Internet in the treatment of people with mental disorders for which the contacts made or maintained by the Internet may decrease sense of alienation and social barriers to overcome. On the other hand, giving access to the Internet carries significant help in increasing employment opportunities. The proposed program is coordinated by the Bródnowskie Stowarzyszenie “Pomost” and implemented together with NGO’s from Germany and the Netherlands, which is an essential component of training on computer use. Conclusions from the study after the application program to a relatively large group, confirm the benefit for patients with acquired skills.

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